Series: Harm at Home
Young children in South Los Angeles continue to live in conditions that harm their health and well-being. In the first of two parts, KPCC investigates why the community still suffers most of the cases of childhood lead poisoning in the city and how concerted efforts to eliminate lead's threat to young children are falling short.
The carpet was stained and faded, the walls needed a fresh coat of paint, and the house vibrated every few minutes as planes from nearby Los Angeles International Airport shuttled in and out.
Yet Monique McClendon, a paralegal student at Los Angeles Trade Technical College, felt relieved she had found a three-bedroom house to shelter her family, including three children and her ailing father.
She had paid $1,800 a month in rent. When she asked the landlord if she could fix the inside of the home to make it a little more habitable, she said the landlord told her: “'It is as is. I really don’t have any money to fix it.'”
What the single mom didn’t realize was that the family’s new home was making her infant son very sick.
Justin, now 3, slept in a crib in McClendon’s bedroom near a window. The breeze at night helped keep him cool, she said, but blew in dust particles laced with lead from the crumbling window frame.
Justin also loved playing on the floor. “When my baby was crawling on the floor … he was touching and putting his hands in his mouth constantly,” McClendon said. “I really didn’t know that by him just touching surfaces, the lead dust from the paint would get him lead poisoned.”
At a routine well-child visit when Justin was two years old, lab results showed a high level of lead in his blood, more than double the base amount that the county health department considers dangerously high. Doctors diagnosed his condition as lead poisoning.
McClendon was shocked. She began researching the topic immediately. “After I had gotten all of the information and started reading, my concerns were his brain activity,” she said.
Dangers of lead for children
Monique McClendon says her son, Justin, loved playing on the floor. "He was touching and putting his hands in his mouth constantly,” she said. McClendon was paying $1,800 a month in rent for the home that she said was making her son sick.
She had cause to worry. The U.S. Centers for Disease Control and Prevention says children suffer brain and nervous system damage from lead poisoning. Exposure can also cause kidney disease, and has been linked to physical and behavioral problems in adulthood.
Eliminating childhood lead poisoning has been a public health priority for decades and mainly for one reason.
“Damage that is done by lead is permanent damage, and it can’t be reversed,” said Debbie Reff, Health Education manager of the Childhood Lead Poisoning Prevention Program for the Los Angeles County Department of Public Health.
Federal housing, environmental and health agencies have all sounded the alarm about the dangers of lead, yet the problem has proven persistent and intractable in many low-income, urban communities across the country.
Official warnings have focused mainly on household paint; harmful levels of lead in paint used in homes have been banned since 1978.
Lead paint turns dangerous when it begins to peel or chip, which is common in very old or dilapidated homes, including those that line the streets in South L.A. The risk of lead poisoning is greatest for small children like Justin, whose brains and bodies are rapidly developing.
Use of lead-based paint had been so pervasive that housing built earlier than 1978 is assumed to have layers of lead paint, according to Jeff Paxton, director of the Code Enforcement Division for the city of Los Angeles that conducts home inspections for hazards like peeling paint.
The CDC and the U.S. Environmental Protection Agency have toughened lead paint regulations, substantially lowering the level of lead in a child's blood that prompts intervention. Contractors who do construction work on properties built before 1978 also face tighter requirements.
While gasoline was once lead-based and a significant source of lead poisoning, the greater risk today comes from homes where lead exposure remains a danger. According to the U.S. Department of Housing and Urban Development, the population most affected nationwide are children in low-income families living in old homes with heavy concentrations of lead-based paint.
South LA at high-risk for lead hazards
Southern California harbors a large stock of older housing, and in some areas, many homes and buildings are deteriorating, their peeling or chipping paint contributing to lead exposure.
Reff's county health department office has tracked old housing across Los Angeles County and mapped the homes of children under six years old who receive Medi-Cal, California's medical program for the poor, aged and disabled.
“South L.A. is in one of the high-risk areas for lead poisoning,” said Reff. “We have seen more cases there of lead-poisoned children.”
Of the children who have tested positive for high blood lead levels and referred to the city's Lead Hazard Remediation Program since the spring, 70 percent are from South L.A., said the agency's Liseth Romero-Martinez.
Caption: The map shows the concentration of people under 21 reported with elevated levels (5-9 ug-DL ) of lead in their blood in Los Angles County in 2011. Such levels should trigger a health assessment. Data source: L.A. County Dept. of Public Health, Childhood Lead Poisoning Prevention Program.
In seeking to eliminate lead poisoning, government officials have shifted their focus from external environmental causes to those close to or inside the home. According to county public health data, 40 percent of all lead-poisoning cases between 2008 and 2012 can be directly traced to children exposed to lead paint hazards within the home. Another 53 percent of cases likely came from exposure around the home: lead in the soil, lead in dust or someone trekking in lead particles from the outside.
Linda Kite, one of the city’s leading consultants on lead and executive director of the Healthy Homes Collaborative, an association of community organizations and agencies working to address unhealthy housing, said one problem in a place like South L.A. is that many homeowners are poor.
“Just because you inherited the property doesn’t mean that you have the resources to repair it,” she said. "Those properties generally — they are inherited or handed down as people die. Then their children will own them and that’s generally who doesn’t have the resources to maintain them in a way where they’re safe for their children."
Both South L.A. and East L.A. have many low-income homeowners, Kite said. “Those are the properties that poison a lot of children, because when you look at the lead levels in those properties, they’re off the charts.”
To properly clean and remediate a dwelling that has window frames with crumbling lead paint or doors that are chipping requires expertise and money, Kite said.
One example: to safely remove lead paint requires a wet-sanding, ensuring dust particles don’t escape into the air. Too often when homeowners try to fix peeling and chipping paint themselves, they are unaware of the dangers, she said.
Some neighborhoods are more affected by lead than others — such as South L.A.'s 90011 zip code, the community tucked in the southeast corner where the 110 and 10 freeways intersect.
“Things to realize about South L.A. and in particular the 90011 zip code, it has the highest incidence of lead poisoning per year as well as historically and cumulatively,” Kite said. “So it's the most lead-poisoned zip code in terms of children who actually get tested and then are actually identified as lead-poisoned.”
Challenges abound in South LA
In the low-income neighborhoods of South Los Angeles, it's not easy getting children tested for lead in their blood.
Kite said Justin’s lucky that his mother took him for regular doctor visits and that the lead in his blood was detected early, but not all low-income kids get regular well-child visits.
For this reason, St. John’s Well Child and Family Centers, one of the largest health care providers in South L.A., has mobile health clinics. A bus is fully equipped like any primary-care doctor's office and rolls into the community on weekends.
When St. John’s pediatricians began seeing too many children with elevated blood lead levels, they reached out to a local community group, Esperanza Community Housing, to dig into the sources of the exposure and work on ways to eliminate them.
Esperanza has worked in South L.A. on housing issues for decades. Executive Director Nancy Ibrahim said her organization has always had a “zero tolerance” policy toward lead risks. While the CDC and L.A. County have their own measures of when a child's lead level prompts action, Ibrahim said for her group, any lead in the blood is a sign that intervention is needed.
After years of advocacy for early intervention in lead cases, California adopted Senate Bill 460 in 2003, allowing local authorities to investigate and inspect potential lead hazards harmful to children and order their abatement.
Ibrahim said too many children were living in rundown apartment buildings where paint was peeling. Despite complaints from tenants about chipping paint, some landlords failed to make repairs. This is where the inspection process helps, as a landlord can be required to resolve the hazardous conditions.
The city of Los Angeles has a systematic code enforcement program (SCEP). Officials inspect rental units once every three years whether or not there have been complaints about the condition of the unit. The Los Angeles County Department of Public Health also has a housing inspection process, and will visit buildings in its jurisdiction — 65,000 structures — that have five or more units, at least once a year.
Yet there are still landlords who don't properly remediate a lead paint hazard, Ibrahim said, leading to the lead poisoning of young children. She said the stepped-up inspections have helped in some cases, but she calls the effort a “work in progress.”
In the trenches, obstacles and resistance
City and county inspectors face multiple challenges as they work to eliminate the lead that can harm the health of children in South Los Angeles.
Gaining access to people’s apartments not only requires someone being at home when the inspector rings the doorbell, it requires trust on the part of the tenant to allow the inspector inside as well as language knowledge in this community where 51.7 percent are Spanish-speakers.
Toby Rodriguez is a health promoter for Esperanza, acting as a liaison and advocate for tenants. He has seen first hand how renters with obvious health-related issues in their apartments will answer the inspectors' knocks and say their apartment is fine when it's not.
"A lot of it is fear of retaliation from the landlord," Rodriguez said. "They’re afraid that, by letting county inspectors in, they may get their rent increased or they may get kicked out." In Los Angeles' tight housing market, where the vacancy rate is 3 percent, there are few low-rent options for families on limited incomes.
Another community organization, Strategic Actions for a Just Economy (SAJE), also serves as a bridge between local authorities and low-income renters.
SAJE runs clinics for tenants where they can learn about their housing rights. At the clinics, organizers frequently hear stories from tenants who struggle with landlords over substandard apartment conditions.
Favian Gonzalez, director of tenant organizing at SAJE, leads a team that finds buildings which appear to have problems across multiple apartments. The group will then seek out tenants to ask if they want to band together, document the problems, and collectively hold the landlord accountable.
The tenants learn about the city code enforcement program and are encouraged to open their doors to city or county inspectors. After working with SAJE, many tenants will allow inspectors in, but other tenants in the building often times do not.
Finding, eliminating lead hazards
Caption: With the help of Strategic Actions for a Just Economy, tenants living in this Wall Street apartment building organized to get the building's roof replaced. (Maya Sugarman/KPCC)
On a Saturday in May, KPCC observed a county inspection of a particularly run-down building on Wall Street in South L.A. “Over the years we are aware that our access has been low,” said Terrance Powell, who oversees inspections for the county public health department. Inspectors now go out later on weekdays, in the evenings, and on Saturday mornings.
On this particular inspection, Carlos Jauregui of SAJE and Gabriela Gonzalez of Esperanza accompanied three county inspectors as they knocked on every door in the Wall Street apartment building.
Jauregui had spent weeks working in the building, talking to tenants about the upcoming inspection and explaining how it might benefit them to let county inspectors into their units. Many of the people he spoke with allowed them entry and pointed out problems with their apartments.
Inspectors found violations in every apartment they inspected, including peeling paint and other serious code violations. When this happens, the landlord gets a letter documenting the problems that need fixing, and they are informed that a follow-up inspection will take place. One month later, records show, a follow-up inspection noted even more violations — and still the peeling paint.
City inspectors have also been in this particular building about one dozen times since 2009, according to city records obtained by KPCC, and violations were found each time, including peeling paint in multiple apartments.
So what happens when inspections repeatedly cite an owner for peeling or chipping paint in an old building? Paxton of L.A.'s Code Enforcement Division said the city has a process to hold landlords accountable.
“If we have orders to fix peeling paint, and they don’t, it should go through our process and end up with the general manager's hearing and then a referral to the city attorney,” Paxton said.
KPCC examined city inspection records for multiple South L.A. apartment buildings and found peeling paint was a repeatedly cited problem. Gonzalez of SAJE said it's a problem in almost all buildings his team has seen.
"Is anyone being held accountable?" he asked.
City can act when landlords don't
Caption: Three-year-old Madeline Cornejo, left, was diagnosed with lead poisoning last year. After several months work toward eliminating the source of the problem, the amount of lead in Cornejo's blood has returned to normal. (Maya Sugarman/KPCC)
As children with lead in their blood continued to show up in doctors' offices, Los Angeles developed the Healthy Homes Collaborative that Kite directs and that brings together community organizations, health providers, lawyers and city and county officials to help fix unhealthy housing conditions.
A U.S. Department of Housing and Urban Development grant program managed by its Office of Lead Hazard Control was key to efforts in Los Angeles, allowing the city to send contractors with expertise into affected buildings to properly remediate the lead dangers. In 1998, Los Angeles received its first HUD grant and began a program in which owners can qualify to have their property lead-remediated if they meet certain criteria: they must be low-income and a child age six or younger must live at the property or regularly visit.
Romero-Martinez, who began managing the city's Lead Hazard Remediation Program in 2007, evaluates properties for lead hazards with her team and sends in health workers to educate families living in affected homes about the health risks.
The average cost for each remediation project is roughly $7,700, according to Jose Berumen, rehab construction specialist with the remediation program. "We try to stay within the cost limits," he said, but the work can be expensive. "The program has justified expenditures of over $20,000 on a single project with prior HUD budget approval," he said.
Since 1998 to 2014, the city records show 1,835 properties — many in South L.A. — have been remediated of lead hazards at a total cost of about $34.5 million.
Three-year-old Maddy Cornejo's home was among the properties remediated of lead hazards by the city.
Berumen's team assessed each part of the home for dangers and lead was found in chipping paint as well as in the soil outside where Maddy and her siblings played. The exterior, roof overhangs, windows, window frames, door frames, interior walls and ceilings were all cleaned. The job took two weeks and cost $28,000.
Knowing lead exposure can have long-term effects, her mother, Sara Cornejo, worries how Maddy will do when her daughter starts school. But for now, she’s working on saving up to get her family a better, healthier place to live.
Caption: Between 1998 and 2014 more than 1,800 homes were remediated or cleaned of lead hazards, according to data from the city of Los Angeles. The map shows where homes remediated between 2006 and early 2015 are clustered. For a larger image of this map, click here. (Source: City of Los Angeles Lead Hazard Remediation Program)